Sobriety in a Bottle

Is Prometa the greatest innovation in addiction treatment history or 21st-century snake oil?

This is the old Mike Briggs. Curled up on the bathroom floor — convulsing, sweating, heart racing. Retching into the toilet. The whites of his eyes shot with red. Every part of his body aching. He wants nothing more than the one thing he knows will put an end to the pain: a shot of vodka.

Every morning, Briggs, a former Marine with a round, Irish face and tints of red on his nose and cheeks, needs a swig to steady his hands enough to shave. He tops off his coffee with vodka from a bottle he keeps hidden beneath the kitchen sink.

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Jody Briggs in the recovery room at Canterbury, where patients say they feel their brain chemistry change

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Mike Briggs sits in the chair where he received his injections of flumazenil.

He'll take another pull before he leaves for his job as production manager at a book publisher. Midmorning, he'll go to his car and sneak a few gulps from a bottle of cheap whiskey. At lunch, he'll down enough to make it to the end of the workday, but by 3:30 p.m., he'll be watching the clock. After work, he drives straight to the bar. When he wakes up the next morning, he starts the whole thing over.

Sometimes he holds the bottle to his lips and says, If there's a God, give me the strength to stop this. Then he takes another drink.

Now this is the new Mike Briggs, four months later. He's strolling around a doctor's office looking healthier than he has in years. His eyes are clear and tranquil. He feels happy, peaceful — unfamiliar emotions. This office, the Prometa Center at the Canterbury Institute in Boca Raton, is where Briggs, 60, says his life drastically and instantaneously changed one day.

It wasn't Jesus, rehab, or AA that did it. In January, he came here for an injection. The price was $13,000, and the drug is not approved by the Food and Drug Administration for treating addiction. But Briggs was told that the shot would forever end his cravings for alcohol.

"It wasn't overnight for me," Briggs says. "It was the same day. It was immediate. After I got the injection, I went to the next room and immediately felt different."

Briggs was given a new treatment for alcohol, cocaine, and methamphetamine addiction called Prometa. Greek for "positive change," Prometa involves three intravenous injections administered over three days in an outpatient setting and 40 days of prescription pills. Cocaine and meth addicts receive two additional injections after a month.

The treatment is marketed by California-based Hythiam Inc., which made headlines two years ago with a series of billboards in Los Angeles depicting the late actor Chris Farley, who died of a drug overdose in 1997. Next to Farley 's picture were the words: "It wasn't all his fault."

"The country is ready," says Chris Hassan, vice president of marketing and development for Hythiam. "People recognize that this is not a choice. This is a disease. It's not a character flaw. It's not a lack of willpower. There is a massive epidemic in this country."

Prometa's detractors say the treatment is 21st-century snake oil — albeit very expensive snake oil. Local addiction experts say that they've seen dozens of chemical treatments over the years promising amazing results but that they've all failed to meet expectations. Dr. Frank Vocci, director of the division of pharmacotherapies and medical consequences for the National Institute on Drug Abuse, says he's skeptical about the effectiveness of Prometa because there has been little clinical research on the treatment. Bruce Alexander, a Canadian psychology professor who has spent most of his life researching addiction, points out that addiction is multifaceted, and he doubts this is the solution.

Across the country, though, patients sing the praises of Prometa to anyone who'll listen. They log into recovery chatrooms and describe the treatment protocol with words like miracle, Godsend, life-saving, and even the most taboo word in the world of addiction: cure.

The drug in the IV is flumazenil, which was originally approved by the FDA to treat overdoses of drugs like Valium. The other Prometa drugs are gabapentin, which goes by the brand name Neurontin and was approved to treat epilepsy and to control seizures, and hydroxyzine, an antihistamine used as an anti-anxiety drug that the Canterbury people liken to "a strong Benadryl." All three medicines are being prescribed "off label" — for something other than what they were approved to do.

Twenty-six minutes after the injection began, Mike Briggs was done with his treatment for the day. He walked across the hall to the recovery room, hungry and tired. As he rested, munching on granola bars and candy, watching Law and Order on the expensive TV in the recovery room, he noticed something. He was happy. It was the first time he could remember feeling completely happy without the aid of alcohol.

Briggs says that for the first time in 48 years, his thoughts are not dominated by alcohol. "It's just another object," he says, like a tree or a chair. "I know alcohol is out there. I can remember drinking. I just don't have the urge to go out and have one."